A non-surgical conservative management of congenital dacryostenosis
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20230923Keywords:
Conservative treatment, Crigler massage, Congenital canaliculus stenosis, Nasolacrimal ductAbstract
Background: Congenital canaliculus stenosis often occurs in about 25-30% of all new born. In many cases, a narrowing of the Nasolacrimal duct can be seen due to a persistent of Hasner membrane. Conservative treatment begins with lacrimal sac massage in the first month of life. This study was conducted to determine non-surgical conservative treatment for congenital lacrimal stenosis in infants and young children. Study design: prospective observational study. The settings are the “Satya eye hospital and research institute”, Kanpur UP from December 2015 to October 2017.
Methods: Nasal sac massage (Crigler massage) with or without topical antibiotics was recommended for 281 children less than 10 months of age diagnosed with congenital canaliculus stenosis. Resolution of lacrimal stenosis was assessed at 4 and 7 months and was defined as the absence of any clinical signs of NLDO. At 7 months, at visits, 244 eyes (83%) of 281 patients showed conservative treatment.
Results: Conservative treatment of CNLD with Crigler massage was successful in most cases treated in 281 (84%) of 335 eyes with congenital canaliculus stenosis. The remaining 54 (16%) eyes were examined. Age (p=0.001) and unilaterality (p=0.001) were found to be associated with the loss of clinical signs.
Conclusions: In this study, we conclude that nonsurgical conservative treatment has a high overall success rate for congenital canaliculus stenosis and that this form of treatment can be considered one of the best options in infants and young children.
References
Young JD, MacEwen CJ. Managing congenital lacrimal obstruction in general practice. BMJ. 1997; 315:293-6.
Kapadia MK, Freitag SK, Woog JJ. Evaluation and management of congenital nasolacrimal duct obstruction. Otolaryngol Clin North Am. 2006;39:959-77.
Ghuman T, Gonzales C, Mazow ML. Treatment of congenital nasolacrimal duct obstruction. Am Orthopt J. 1999;49:163-8.
Durrani J. Crigler massage for congenital blockade of nasolacrimal duct. J Coll Physicians Surg Pak. 2017; 27:145-8.
MacEwen CJ, Young JDH. Epiphora during the First Year of Life. Eye (Lond). 1991;5:596-600.
MacEwan CJ, Young JDH. The fluorescein disappearance test: an evaluation of its use in infants. J Pediatr Ophthalmol Strabismus. 1991;28:302-5.
Crigler LW. The treatment of congenital dacryocystitis. JAMA. 1923;81:23-4.
Noda S, Hayasaka S, Setogawa T. Congenital nasolacrimal duct obstruction in Japanese infants: its incidence and treatment with massage. J Pediatr Ophthalmol Strabismus. 1991;28:20-2.
Zappia RJ, Milder B. Lacrimal drainage function: the fl uorescein dye disappearance test. Am J Ophthalmol. 1972;74:160-2.
Nelson LB, Calhoun JH, Menduke H. Medical management of congenital nasolacrimal duct obstruction. Pediatr. 1985;76:172-5.
Petersen RA, Robb RM. The natural course of congenital obstruction of the nasolacrimal duct. J Pediatr Ophthalmol Strabismus. 1978;15:246-50.
Kakijaki H, Takahashi Y, Kinoshita S, Shiraki K, Iwaki M. The rate of symptomatic improvement of congenital nasolacrimal duct obstruction in Japanese infants treated with conservative management during 1st year of age. Ophthalmology. 2008;2:291-4.
Young JDH, MacEwen CJ, Ogston SA. Congenital nasolacrimal duct obstruction in the second year of life: A multicentre trial of management. Eye. 1996;10:485-91.
Katowitz JA, Welsh MG. Timing of initial probing and irrigation in congenital buct obstruction. Ophthalmology. 1987;94:698-705.
Piest KL, Katowitz JA. Traetment of congenital nasolactrimal duct obstruction. Ophthalmol Clin North Am. 1991;4:201-9.
Noda S, Hayasaka S, Setogawa T. Congenital nasolacrimal duct obstruction in Japanese infants: its incidence and treatment with massage. J Pediatr Ophthalmol Strabismus. 1991;28:20-2.
Nelson LB, Calhoun JH, Men duke H. Medical management of congenital nasolacrimal duct obstruction. Paediatrics. 1985;76:172-5.
Kakizaki H, Takahashi Y, Kinoshita S, Shirak K, Iwaki M. The rate of symptomatic improvement of congenital nasolacrimal duct obstruction in Japanese infants treated with conservative management during the 1st year of age. Clan Ophthal. 2008;2:291-4.
Takahashi Y, Kakizaki H, Chan WO, Selva D. Management of congenital nasolacrimal duct obstruction. Acta Ophthalmol. 2010;88:506-13.
Nucci P, Capoferri C, Alfarano R, Brancato R. Conservative management of congenital nasolacrimal duct obstruction. J Pediatr Ophthalmol Strabismus. 1989;26:39-43.
Baker JD. Treatment of congenital nasolacrimal system obstruction. J Pediatr Ophthalmol Strabismus. 1985;22:34-6.